Chemotherapy Treatment with FOLFOX: Examining Potential Side Effects, Treatment Plan, and Success Probabilities
FOLFOX is a combination of chemotherapy drugs commonly used to treat colorectal cancers, particularly if the cancer has spread beyond the colon. This treatment regimen is a standard option for stage II and III colon and rectal cancer, as well as some advanced or metastatic colcolorectal cancers.
Types of Cancer Treated with FOLFOX
FOLFOX is often used as an adjuvant therapy, which means it is administered after the primary cancer treatment such as surgery. In the case of locally advanced rectal cancer, FOLFOX or combinations like FOLFIRINOX are used after chemoradiation therapy to improve response rates and potentially avoid surgery.
For metastatic colorectal cancer, FOLFOX is part of regimens for unresectable or metastatic colorectal cancer, sometimes combined with targeted therapies for patients with specific mutations such as BRAF. FOLFOX is also used in combination therapies for certain advanced solid tumors including HER2-overexpressing gastric and esophageal adenocarcinomas.
Common Side Effects of FOLFOX
Side effects of FOLFOX treatment may include gastrointestinal issues, neurological issues, increased risk of infection, skin problems, anemia, fatigue, bruising and bleeding, fever, difficulty breathing or swallowing, and hair loss. Peripheral sensory neuropathy due to oxaliplatin is a frequent and sometimes dose-limiting toxicity.
Success Rates and Outcomes
Studies such as MOSAIC, NSABP C-07, and XELOXA have demonstrated significant improvement in disease-free survival and a 12-17% reduction in risk of death for stage III colon cancer when adding oxaliplatin (as in FOLFOX) to fluoropyrimidines. Median progression-free survival (PFS) for advanced gastric/esophageal cancers treated with FOLFOX + trastuzumab + immunotherapy reached around 8 months, with overall survival (OS) of about 13 months.
For metastatic colorectal cancer with BRAF mutations, intensified regimens involving FOLFOX derivatives combined with targeted drugs improve response rates but may not significantly extend overall survival compared to some doublet therapies.
In summary, FOLFOX is chiefly effective and commonly used in colorectal cancers at various stages, with well-documented survival benefits particularly in adjuvant and metastatic settings. Side effects include neuropathy, gastrointestinal issues, and myelosuppression, with success rates depending on cancer type and stage but generally showing improved survival metrics compared to older regimens without oxaliplatin.
A 2016 study found that FOLFOX significantly increases the 5-year overall survival rate in people with stage 3 colon cancer who receive at least eight cycles. According to this study, there are significant benefits for people with stage 3 colon cancer who receive at least eight cycles of FOLFOX.
Each cycle of FOLFOX lasts for 2 weeks. Individuals typically receive FOLFOX through intravenous (IV) infusions at a chemotherapy clinic. Oxaliplatin is administered over 2 hours, while folinic acid and fluorouracil are given as injections or infusions. Folinic acid is given on Day 1 and Day 2 of the cycle, while the fluorouracil infusion lasts for 22 hours. An individual may receive up to 12 cycles of FOLFOX.
XELOX (also called CAPOX) is another chemotherapy regimen that uses oxaliplatin combined with capecitabine. A central line can be used for FOLFOX infusions at home. A sample FOLFOX regimen includes oxaliplatin, folinic acid, and fluorouracil.
A 2019 study found no significant differences in survival rates between FOLFOX and FOLFIRI in people with stage 4 colon cancer, but FOLFOX was more commonly used.
- FOLFOX, when used in the treatment of colorectal cancer, has shown significant improvements in disease-free survival for stage III colon cancer, reducing the risk of death by 12-17%.
- Colonoscopy, a medical-condition screening, is crucial for early detection of colorectal cancer, as it allows doctors to identify and remove precancerous polyps before they develop into cancer.
- The use of science and advancements in health-and-wellness, such as FOLFOX, has been instrumental in the treatment and management of cancer, notably in improving survival rates for people with colorectal cancer.
